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Sharma D, Douglas J, Begley A, Hutchison I, Magennis P. United Kingdom oral and maxillofacial surgeons support changes to current specialty recruitment process, which could include 'Walport' style local selection and national benchmarking. Br J Oral Maxillofac Surg 2024; 62:483-488. [PMID: 38714378 DOI: 10.1016/j.bjoms.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/11/2024] [Accepted: 03/15/2024] [Indexed: 05/09/2024]
Abstract
Recruitment to oral and maxillofacial Surgical (OMFS) specialty training was centralised in 2010. The 'flexibility' for OMFS to respond to specialty specific recruitment issues is reducing and many Specialty Trainees' (ST) posts are left unfilled. The National Institute for Health and Care Research (NIHR) appointment process designed to address the problem of recruiting and appointing academic surgeons with local selection with national benchmarking has worked. Using a database of all UK OMFS consultants/trainees, an electronic questionnaire was shared by e-mail, WhatsApp, and other social media. Of 306 replies, 125 (41%) were Consultants/post-certificate of completion training (CCT) individuals, 66 (22%) ST, 61 (20%) second degree students, 27 (9%) pre-second degree, 26 (9%) dual degree pre-ST trainees, and one did not indicate their status. A total of 249 (76%) studied dentistry first and 230 (75%) were male. Of those replying, 147 (48%) had no direct experience of national selection. 120 (39%) had experience as a candidate, 20 (7%) as a selector only, 17 (6%) as a candidate and selector, and two did not record their experience. Of 250 expressing an opinion, 156 (62%) supported local selection with 140 (56%) supporting local selection and national benchmarking, which is a process used for research training posts by the NIHR. Geographical continuity was most important for 78% of pre-second-degree trainees, 45% of STs, and 54% of second-degree students. A total of 57 respondents completed free text comments. There is support for changes in OMFS ST selection including creating OMFS posts which include Foundation and second-degree training in NIHR style locally recruited nationally benchmarked posts.
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Affiliation(s)
- Divya Sharma
- University Hospitals Bristol and Weston, United Kingdom.
| | - James Douglas
- OMFS Specialty Trainee Yorkshire & Humber, United Kingdom.
| | - Anne Begley
- Consultant OMFS - Aintree University Hospitals NHS Trust, United Kingdom.
| | - Iain Hutchison
- Barts and The London Institute of Dentistry, United Kingdom.
| | - Patrick Magennis
- Consultant OMFS - Aintree University Hospitals NHS Trust, United Kingdom.
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Sharma D, Douglas J, Begley A, Magennis P, Koppel D. UK OMFS consultants and trainees strongly support the recommendations of the 2008 Postgraduate Medical Education and Training Board (PMETB) Review of Training in OMFS. The time for delivering them is now. Br J Oral Maxillofac Surg 2024; 62:477-482. [PMID: 38692979 DOI: 10.1016/j.bjoms.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/24/2024] [Indexed: 05/03/2024]
Abstract
When the Postgraduate Medical Education and Training Board's (PMETB) Review of Oral and Maxillofacial Surgery (OMFS) Training was published in 2008 it contained five recommendations about OMFS training. As yet, none of these recommendations has been delivered. An online survey was designed to assess awareness of the PMETB review and the current views of OMFS trainees and consultants about its recommendations. Replies were invited using email and social media (WhatsApp, Twitter, and Facebook). As a result of using social media no denominator for the response rate was possible. A total of 304 responses were received, eight of which were anonymous. There was strong support for all the OMFS-specific recommendations: 1: the OMFS specialty should remain a dual medical and dental degree specialty (255, 84%); 2: OMFS training should be shortened (283, 93%); 3: OMFS training should start at the beginning of the second degree (203, 67%); 4: there should be a single medical regulator (General Medical Council) for OMFS (258, 85%); and 6: the need for a second Foundation Year should be removed (260, 86%). Other suggestions about improving OMFS training were also made by participants in the survey. There remains strong support within the specialty for the recommendations of the review. This support is present across consultants, specialty trainees, and those aiming for OMFS specialty training. Some of the original legislative obstructions to delivery of the recommendations have been removed by Brexit creating a unique opportunity for them to be delivered.
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Affiliation(s)
| | | | - Anne Begley
- Liverpool University Hospitals NHS Foundation Trust, UK.
| | | | - David Koppel
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.
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Sohaib Sarwar M, Rehman U. Re: Improving medicine first trainee experience in oral and maxillofacial surgery. Br J Oral Maxillofac Surg 2024; 62:310-311. [PMID: 38431505 DOI: 10.1016/j.bjoms.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/26/2023] [Indexed: 03/05/2024]
Affiliation(s)
- Mohammad Sohaib Sarwar
- Locum Clinical Fellow, Department of Oral and Maxillofacial Surgery, The Queen Victoria Hospital, East Grinstead, United Kingdom.
| | - Umar Rehman
- Clinical Research Fellow, UCL Division of Surgery and Interventional Sciences, UCL, London, United Kingdom.
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Hutchison I. Reprint of: Citation for award of Down Surgical Prize 2020 to Patrick Magennis. Br J Oral Maxillofac Surg 2023; 61:255-257. [PMID: 37080664 DOI: 10.1016/j.bjoms.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 04/22/2023]
Affiliation(s)
- Iain Hutchison
- Barts and the London School of Medicine and Dentistry, United Kingdom.
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Perwaiz I, Rehman U, Sarwar MS, Brennan PA. What are the concerns of second-degree medical students entering specialty OMFS training? Br J Oral Maxillofac Surg 2023; 61:147-151. [PMID: 36797121 DOI: 10.1016/j.bjoms.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Oral and maxillofacial surgery (OMFS) applicants are faced with numerous challenges. Previous research has demonstrated that financial burden, length of OMFS training, and impact on personal life are cited as major drawbacks to pursuing the specialty, with trainees having concerns about the Membership of the Royal College of Surgeons (MRCS) examinations. The current study aimed to explore second-degree medical students' concerns about obtaining a specialty training post in OMFS. An online survey was distributed via social media to second-degree students across the United Kingdom and 106 responses were received. A lack of publications and lack of involvement in research (54%) as well as attaining accreditation with the Royal College of Surgeons (27%) were cited as the primary and secondary concerns in relation to securing a higher training post. Seventy-five per cent of respondents had no first-author publications, 93% expressed concerns about passing the MRCS examination, and 73% had more than 40 OMFS procedures within their logbook. Second-degree medical students reported having ample clinical and operative experience in OMFS. Their main concerns were about research and MRCS examinations. To alleviate these concerns, BAOMS could provide educational initiatives and dedicated mentorship programmes for second-degree students, and could adopt a collaborative approach with discussion with major postgraduate training stakeholders.
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Affiliation(s)
- Ibrar Perwaiz
- Department of General Surgery, Calderdale and Huddersfield NHS Foundation Trust, Huddersfield, United Kingdom.
| | - Umar Rehman
- Department of Surgery, Northwick Park Hospital, London, United Kingdom.
| | - Mohammad Sohaib Sarwar
- Department of Oral and Maxillofacial Surgery, The Queen Victoria Hospital, East Grinstead, United Kingdom.
| | - Peter A Brennan
- Consultant Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, United Kingdom.
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Magennis P, Hölzle F, Ulrich HP, Acero J, Hutchison I. The specialty of oral and maxillofacial surgery (OMFS) in Europe – Part 1: service configuration, regulation, and provision. Br J Oral Maxillofac Surg 2022. [DOI: 10.1016/j.bjoms.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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The Specialty of Oral and Maxillofacial Surgery (OMFS) In Europe – Part 2 Training Environment including the new Union of European Medical Specialists (UEMS) Oral and Maxillofacial Surgery European Training Requirement (OMFS ETR). Br J Oral Maxillofac Surg 2022. [DOI: 10.1016/j.bjoms.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Citation for Award of Down Surgical Prize 2020 to Patrick Magennis. Br J Oral Maxillofac Surg 2022; 60:e5-e7. [DOI: 10.1016/j.bjoms.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022]
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Magennis P, Begley A, Dhariwal DK, Smith A, Hutchison I. Oral and Maxillofacial Surgery (OMFS) Consultant Workforce in the UK: reducing consultant numbers resulting from recruitment issues, pension pressures, changing job-plans, and demographics when combined with the COVID backlog in elective surgery, requires urgent action. Br J Oral Maxillofac Surg 2021; 60:14-19. [PMID: 34844827 DOI: 10.1016/j.bjoms.2021.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 10/27/2021] [Indexed: 11/18/2022]
Abstract
Mean retirement age for UK doctors is 59.6 years, giving the average OMFS consultant approximately 20 years of practice. Current pension tax regulations, new consultant posts typically restricted to a maximum of 10 sessions (40 hours), increasing proportions of consultants working less than full time (LTFT), all combined with the backlog of elective care created by COVID-19 will create a significant gap between workforce capacity and clinical demand. The age of current OMFS consultants was estimated using the date of their primary medical/dental qualification. Changes in job plans were estimated using data from the BAOMS Workforce Census and from recently advertised posts. Reports of unfilled posts were collated by OMFS Regional Specialty Professional Advisors (RSPAs). First degree dates were identified for 476 OMFS substantive consultant posts. Estimated current average age of OMFS consultants was 52.7 years (minimum 35.9, maximum 72.1), 75th centile age 59.0 and 23% of the current consultant workforce above the average retirement age for doctors. The 10 sessions of new OMFS consultants posts is significantly less than existing consultants' average of 12.1 sessions (48.4 hours). Unfilled consultant posts in Great Britain are 13% of total compared to 20% in Northern Ireland and Ireland. Many (23%) of the OMFS consultant workforce are above average retirement age. Forty-hour contracts; new consultants working LTFT; and early loss of senior colleagues because of pension pressure will reduce NHS' capacity to treat OMFS disorders and injuries. This paper suggests increasing consultant posts, increasing trainee numbers, and actively retaining senior surgeons to maintain capacity.
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Affiliation(s)
- Patrick Magennis
- Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
| | - Anne Begley
- Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
| | | | - Austen Smith
- OMFS Surgeon, Sheffield and Barnsley Hospitals NHS Foundation Trust, United Kingdom.
| | - Iain Hutchison
- Institute of Dentistry, Barts and The London, United Kingdom.
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Magennis P, Dhariwal DK, Hölzle F, Smith A, Hutchison I. Impact of Brexit - 2020 may be the first year in a decade when no new Oral and Maxillofacial Surgery (OMFS) trainees or new OMFS specialists from Europe started working in the UK. Br J Oral Maxillofac Surg 2021; 60:86-87. [PMID: 34916097 DOI: 10.1016/j.bjoms.2021.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Frank Hölzle
- Department of OMFS, RWTH Aachen University Hospital, Aachen, Germany.
| | - Austen Smith
- Sheffield and Barnsley Hospitals NHS Foundation Trust, United Kingdom.
| | - Iain Hutchison
- Barts and The London Institute of Dentistry, United Kingdom.
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Magennis P, Begley A, McLean A, Rapaport B, Dhariwal DK, Brennan PA, Hutchison I. The UK Mentoring and Support Programme (MSP) for those considering a career in Oral and Maxillofacial Surgery (OMFS). A review of a 'Register Interest in OMFS' website and the MSP as two key resources created by the British Association of Oral and Maxillofacial Surgeons to promote recruitment and retention (2008-2020). Br J Oral Maxillofac Surg 2020; 59:935-940. [PMID: 34400024 DOI: 10.1016/j.bjoms.2020.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/01/2020] [Indexed: 11/17/2022]
Abstract
In 2008, to create a rapid route for information transfer in relation training and recruitment for OMFS trainees, the British Association of Oral and Maxillofacial Surgeons (BAOMS) created a website to "Register Your Interest in OMFS" (RYIO). From 2011 a Mentoring and Support Programme (MSP) was created to provide focussed guidance for trainees aiming for specialty training. This paper reviews the effectiveness and cost of these programmes. Between 2008 and 2020, 1744 individuals used RYIO on 2715 occasions. Of these registrations, 1772 were by dentists, 193 dental students, 589 doctors and 161 medical students. 2354 were from UK and Ireland and 351 from the rest of the world. 188 registrants subsequently became UK OMFS trainees or specialists. All registrants valued the information provided. In response to RYIO trainee feedback the new 'Taste of OMFS 2020' programme was created. The MSP was originally called the Junior Trainee Programme (JTP). The MSP scheme provides a layer of mentorship/support which runs parallel to the medical/dental training post or period of study. Of 180 members of MSP, 72 have obtained specialty training posts in OMFS. There are 88 current members. Full information is available on the BAOMS website www.baoms.org.uk. Reviewing both programmes, participant feedback is excellent with tangible results whilst cost effectiveness is high.
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Affiliation(s)
- P Magennis
- Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
| | - A Begley
- Liverpool University Hospitals NHS Foundation Trust, United Kingdom.
| | - A McLean
- University of Liverpool, United Kingdom.
| | - B Rapaport
- University of Liverpool, United Kingdom.
| | - D K Dhariwal
- John Radcliffe Hospital, Oxford, United Kingdom.
| | | | - I Hutchison
- Institute of Dentistry, Barts and The London, United Kingdom.
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